Dorsal inlay graft urethroplasty for primary hypospadiac repair
Dorsal inlay graft urethroplasty for primary hypospadiac repair
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DOI：
10.1111/j.1442-2042.2006.01662.x
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发表时间：
2007-01-01
影响因子：
2.6
通讯作者：
Shishido, Seiichiro
中科院分区：
文献类型：
--
作者：
Asanuma, Hiroshi;Satoh, Hiroyuki;Shishido, Seiichiro
目的：管状切板尿路成形术已成为许多机构修复远端和近端尿道下裂的常用方法。背部嵌体移植物尿路成形术自2003年以来一直在我们机构使用，以降低尿道口狭窄的风险。在本研究中，我们评估了背部嵌体移植物的结果。方法：28例无深沟、无严重曲度的患者接受了一期包皮背部嵌体移植物的尿路成形术。结果：患者手术时年龄14个月~4.6岁，平均21个月。术前尿道口为冠状2例，远端17例，近端6例，3例。9名患者在手术前接受了睾丸素治疗。手术时间154~249min，平均200min。嵌体移植长度12~30 mm，平均20.9 mm。所有患者阴茎伸直，阴茎无海绵体背侧折叠，新生阴茎位于龟头尖端，外观呈裂隙状。在平均22个月的随访中，只有一名患者(3.6%)出现尿路皮瘘，需要在尿路成形术后6个月进行修复手术。结论：背侧嵌体移植物尿路成形术是治疗尿道下裂的一种有效方法，美容效果好，并发症发生率低。
Objective: Tubularized incised plate urethroplasty has become a popular technique for repairing distal and proximal hypospadias in many institutions. Dorsal inlay graft urethroplasty has been used in our institution since 2003 to reduce the risk of meatal stenosis. In the present study, we evaluated the results of the dorsal inlay graft procedure.Methods: A total of 28 patients with no deep groove and no severe curvature underwent one-stage urethroplasty using an inner preputial-based dorsal inlay graft. The medical records of all patients were retrospectively reviewed with regard to complication rate and cosmetic appearance.Results: Mean patient age at surgery was 21 months (range, 14 months to 4.6 years). Preoperatively the urethral meatus was coronal in two cases, distal shaft in 17, proximal shaft in six and penoscrotal in three. Nine patients required testosterone therapy before surgery. Mean operative time was 200 min (range, 154-249 min). Mean length of inlay graft was 20.9 mm (range, 12-30 mm). In all patients, a straight penis was achieved without dorsal plication of the corposa cavernosa, and the neomeatus with a slit-like appearance was positioned at the glans tip. At a mean of 22 months of follow up, a urethrocutaneous fistula developed in only one patient (3.6%), requiring repair surgery 6 months after urethroplasty. No patient had meatal stenosis, neourethral stricture or urethral diverticulum along the inlay graft.Conclusion: Dorsal inlay graft urethroplasty is an effective method for hypospadiac repair and leads to good cosmetic outcome with low risk of complications.